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What is Panic Disorder?
People with panic disorder have sudden and repeated attacks of fear that last for several minutes. Sometimes symptoms may last longer. These are called panic attacks. Panic attacks are characterized by a fear of disaster or of losing control even when there is no real danger. A person may also have a strong physical reaction during a panic attack. It may feel like having a heart attack. Panic attacks can occur at any time, and many people with panic disorder worry about and dread the possibility of having another attack.
A person with panic disorder may become discouraged and feel ashamed because he or she cannot carry out normal routines like going to the grocery store or driving. Having panic disorder can also interfere with school or work.
Causes
Panic disorder sometimes runs in families, but no one knows for sure why some people have it while others don't. Researchers have found that several parts of the brain are involved in fear and anxiety. By learning more about fear and anxiety in the brain, scientists may be able to create better treatments. Researchers are also looking for ways in which stress and environmental factors may play a role.
Signs & Symptoms
People with panic disorder may have:
Who Is At Risk?
Panic disorder affects about 6 million American adults and is twice as common in women as men. Panic attacks often begin in late adolescence or early adulthood, but not everyone who experiences panic attacks will develop panic disorder. Many people have just one attack and never have another. The tendency to develop panic attacks appears to be inherited.
Diagnosis
Panic attacks can occur at any time, even during sleep. An attack usually peaks within 10 minutes, but some symptoms may last much longer.
People who have full-blown, repeated panic attacks can become very disabled by their condition and should seek treatment before they start to avoid places or situations where panic attacks have occurred. For example, if a panic attack happened in an elevator, someone with panic disorder may develop a fear of elevators that could affect the choice of a job or an apartment, and restrict where that person can seek medical attention or enjoy entertainment.
Some people's lives become so restricted that they avoid normal activities, such as grocery shopping or driving. About one-third become housebound or are able to confront a feared situation only when accompanied by a spouse or other trusted person. When the condition progresses this far, it is called agoraphobia, or fear of open spaces.
Early treatment can often prevent agoraphobia, but people with panic disorder may sometimes go from doctor to doctor for years and visit the emergency room repeatedly before someone correctly diagnoses their condition. This is unfortunate, because panic disorder is one of the most treatable of all the anxiety disorders, responding in most cases to certain kinds of medication or certain kinds of cognitive psychotherapy, which help change thinking patterns that lead to fear and anxiety.
Panic disorder is often accompanied by other serious problems, such as depression, drug abuse, or alcoholism.These conditions need to be treated separately. Symptoms of depression include feelings of sadness or hopelessness, changes in appetite or sleep patterns, low energy, and difficulty concentrating. Most people with depression can be effectively treated with antidepressant medications, certain types of psychotherapy, or a combination of the two.
First, talk to your doctor about your symptoms. Your doctor should do an exam to make sure that another physical problem isn't causing the symptoms. The doctor may refer you to a mental health specialist.
Treatments
Panic disorder is generally treated with psychotherapy, medication, or both.
Psychotherapy. A type of psychotherapy called cognitive behavior therapy is especially useful for treating panic disorder. It teaches a person different ways of thinking, behaving, and reacting to situations that help him or her feel less anxious and fearful.
Medication. Doctors also may prescribe medication to help treat panic disorder. The most commonly prescribed medications for panic disorder are anti-anxiety medications and antidepressants. Anti-anxiety medications are powerful and there are different types. Many types begin working right away, but they generally should not be taken for long periods.
Antidepressants are used to treat depression, but they also are helpful for panic disorder. They may take several weeks to start working. Some of these medications may cause side effects such as headache, nausea, or difficulty sleeping. These side effects are usually not a problem for most people, especially if the dose starts off low and is increased slowly over time. Talk to your doctor about any side effects you may have.
It's important to know that although antidepressants can be safe and effective for many people, they may be risky for some, especially children, teens, and young adults. A "black box"—the most serious type of warning that a prescription drug can have—has been added to the labels of antidepressant medications. These labels warn people that antidepressants may cause some people to have suicidal thoughts or make suicide attempts. Anyone taking antidepressants should be monitored closely, especially when they first start treatment with medications.
Another type of medication called beta-blockers can help control some of the physical symptoms of panic disorder such as excessive sweating, a pounding heart, or dizziness. Although beta blockers are not commonly prescribed, they may be helpful in certain situations that bring on a panic attack.
Some people do better with cognitive behavior therapy, while others do better with medication. Still others do best with a combination of the two. Talk with your doctor about the best treatment for you.
Living With
"One day, without any warning or reason, I felt terrified. I was so afraid, I thought I was going to die. My heart was pounding and my head was spinning. I would get these feelings every couple of weeks. I thought I was losing my mind."
"The more attacks I had, the more afraid I got. I was always living in fear. I didn't know when I might have another attack. I became so afraid that I didn't want to leave my house."
"My friend saw how afraid I was and told me to call my doctor for help. My doctor told me I was physically healthy but that I have panic disorder. My doctor gave me medicine that helps me feel less afraid. I've also been working with a counselor learning ways to cope with my fear. I had to work hard, but after a few months of medicine and therapy, I'm starting to feel like myself again."
web md
Panic disorder is different from the normal fear and anxiety reactions to stressful events in our lives. Panic disorder is a serious condition that strikes without reason or warning. Symptoms of panic disorder include sudden attacks of fear and nervousness, as well as physical symptoms such as sweating and a racing heart. During a panic attack, the fear response is out of proportion for the situation, which often is not threatening. Over time, a person with panic disorder develops a constant fear of having another panic attack, which can affect daily functioning and general quality of life.
Panic disorder often occurs along with other serious conditions, such asdepression, alcoholism, or drug abuse.
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What Are the Symptoms of Panic Disorder?
Symptoms of a panic attack, which often last about 10 minutes, include:
Beyond the panic attacks themselves, a key symptom of panic disorder is the persistent fear of having future panic attacks. The fear of these attacks can cause the person to avoid places and situations where an attack has occurred or where they believe an attack may occur.
What Causes Panic Disorder?
Although the exact cause of panic disorder is not fully understood, studies have shown that a combination of factors, including biological and environmental, may be involved. These factors include.
How Common Is Panic Disorder?
Panic disorder affects about 2.4 million adult Americans. Panic disorder most often begins during late adolescence and early adulthood. It is twice as common in women as in men.
How Is Panic Disorder Diagnosed?
If symptoms of panic disorder are present, the doctor will begin an evaluation by performing a complete medical history and physical exam. Although there are no lab tests to specifically diagnose panic disorder, the doctor may use various tests to look for physical illness as the cause of symptoms.
If no physical illness is found, you may be referred to a psychiatrist or psychologist,mental health professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for panic disorder.
The doctor bases his or her diagnosis on reported intensity and duration of symptoms, including the frequency of panic attacks, and the doctor's observation of the patient's attitude and behavior. The doctor then determines if the symptoms and degree of dysfunction suggest panic disorder.
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Panic Disorder
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AAAHow Is Panic Disorder Treated?
A combination of the following therapies is often used to treat panic disorder.
Some people will respond well to treatment only to experience panic attacks later in life. When panic attacks continue after treatment has stopped, additional treatment may still help control and reduce panic attacks. In addition, relaxation techniques, such as breathing retraining and positive visualization, may help a person during an attack.
What Is the Outlook for People With Panic Disorder?
Panic disorder can be successfully treated, and sufferers can go on to lead full and satisfying lives. With appropriate treatment, nearly 90% of people with panic disorder can find relief. Unfortunately, many people with panic disorder do not seek treatment. Without treatment, panic disorder can have serious consequences and can severely impair quality of life. Complications of untreated panic disorder include.
Can Panic Disorder Be Prevented?
Panic disorder cannot be prevented; however, there are some things you can do to reduce stress and decrease symptoms, including: